INFORMAL-FORMAL CAREGIVER RELATIONSHIPS WITHIN CARE ...

INFORMAL-FORMAL CAREGIVER INFORMAL-FORMAL CAREGIVER INFORMAL-FORMAL CAREGIVER RELATIONSHIPS WITHIN CARE NETWORKS OF OLDER ADULTS.

INFORMAL-FORMAL CAREGIVER RELATIONSHIPS WITHIN CARE NETWORKS OF OLDER ADULTS.

MARIANNE JACOBS, MSc.11PROF. DR. MARJOLEIN BROESE VAN GROENOU1,

PROF. DR. PETER GROENEWEGEN2

1VU UNIVERSITY, DEPARTMENT OF SOCIOLOGY2VU UNIVERSITY, DEPARTMENT OF ORGANIZATION SCIENCES

BACKGROUNDBACKGROUND

Rising demand for long-term care for older adults

Shifting responsibilities in both informal and formal care

Policy in Western countries aimed at cooperation: ‘A good connection

between informal and formal caregivers is in the interest of all parties

involved’ (Ministry of Health, Welfare and Sport).

Research (e.g. Jody Gittell: Cooperation is a prerequisite for a good

quality of care)

Mixed care networks

2 Informal-formal caregiver relationships within care networks of older adults.

THEORETICAL FRAMEWORKTHEORETICAL FRAMEWORK

If and when informal and formal caregivers contact each

other can be explained by:

Characteristics of the older adult: age sex functionalCharacteristics of the older adult: age, sex, functional

limitations

Size, proportion of informal caregivers in the care network

Dyadic characteristics: Similarity of tasks (task overlap);

meeting opportunities (number of hours and years involved)


SAMPLESAMPLE

- 119 older adults identified via eight homecare organizations and three voluntary care organizations inorganizations and three voluntary care organizations in Amsterdam and surroundings

- 75 older adults eventually participated:- They were cognitively able to participate in a face-to-face interview- They were aged 65 or older- They received care from at least two types of the following caregivers:

informal caregivers, formal caregivers or volunteers.

- 94 informal caregivers and 102 formal caregivers are interviewed as wellinterviewed as well


METHODS: EGO-NETWORK OLDER ADULTMETHODS: EGO-NETWORK OLDER ADULT

> For each caregiver:a b

• Relationship to older adult (e.g. partner, nurse))

• Hours of careOLDER

f

• Duration

T pe of care (task

ADULTc

• Type of care (task overlap) e

Faculty of Social Sciences6 Informal-formal caregiver relationships within care networks of older adults.

d

METHODS: CAREGIVING NETWORKMETHODS: CAREGIVING NETWORK

> Cooperation with other caregivers: a b Informal

caregiver

Formalcaregiver

g

> Frequency of contact with..

caregiver

> How well can you cooperate with.. OLDER

fp

> How often do you experience friction

ADULTc

pwith..

e

Faculty of Social Sciences7 Informal-formal caregiver relationships within care networks of older adults.

d

VARIABLESVARIABLES

Older adult and network: Formal and informal caregiver:

Sex & Age

IADL and ADL limitations

Perceived control of the care

Relationship

Hours

DurationPerceived control of the care

Number of caregivers

Proportion informal CG

Duration

Number of tasks

Task overlapProportion informal CG Task overlap

Dependent variable: Contact with other CG (yes/no)


RESULTS: OLDER ADULT CHARACTERISTICS (N=74)RESULTS: OLDER ADULT CHARACTERISTICS (N=74)

Mean/% SD

% Female 68

Mean age in years (66-99) 83 30 7 67Mean age in years (66 99) 83.30 7.67

Mean IADL & ADL limitations (17-74) 35.69 11.16

% Perceived control of the care% Perceived control of the careOlder adult onlyOlder adult with CGCG l

151960CG only 60


RESULTS: NETWORK CHARACTERISTICSRESULTS: NETWORK CHARACTERISTICS

Mean SD

Number of informal CGs (1-9) 2.97 2.05

N b f f l CG (1 18) 5 82 3 75Number of formal CGs (1-18) 5.82 3.75

Total number of CGs (2-22) 8.80 4.42

Proportion of informal CGs (0.08-0.83) 0.36 0.19


NETWORK SIZE BY SEX NETWORK SIZE BY SEX

12

Total number of caregivers

10

6

8

Informal CG

4

6 Informal CGFormal CG

2p=0.01


0Male Female

RESULTS: INFORMAL- AND FORMAL CAREGIVER CHARACTERISTICSRESULTS: INFORMAL- AND FORMAL CAREGIVER CHARACTERISTICS

Contact30%

No contact70%

P-value

Relation informal CG1 Partner and children (in law)2 Oth f il

64.330 7

35.769 3

<0.012 Other family3 Friends/neighbours/acquintances4 Volunteers

30.724.52.1

69.375.597.9

Relation formal CG1 Household carer 22.0 78.0 <0.012 Personal carer3 Nurse4 Other

33.336.819 2

66.763.280 8


4 Other 19.2 80.8


Contact30%

No contact70%

P-value

Mean hours informal CG (0-112) 12.62 4.52 <0.01

Mean duration informal CG in years (0-32)

6.59 4.65 <0.01

Mean hours formal CG (0-21.75) 4.26 4.04 0.54

Mean duration formal CG in years (0- 3.70 4.01 0.47ea du at o o a CG yea s (034)

3 0 0 0

% Task overlap (vs. not) 31.6 21.4 0.01



Contact30%

No contact70%

P-value30% 70%

Number of tasks informal CG1 17.1 82.9 <0.01234

48.752.978 6

51.347.121 44 78.6 21.4

Number of tasks formal CG1 26.0 74.0 <0.0123

44.750.0

55.350.0


RESULTS: MULTILEVEL REGRESSION ANALYSIS (N DYADS=508)RESULTS: MULTILEVEL REGRESSION ANALYSIS (N DYADS=508)

Model 1 Model 3

IADL and ADL limitations older adult 0.043** 0.031

Total number of caregivers -0.101* -0.077

Proportion informal caregivers -4.531*** -3.010

Number of tasks informal caregiver (1-2+) 1.944***g ( )

Number of tasks formal caregiver (1-2+) 1.682**

Informal CG=partner or child 1 360**

*p<0.05 **p<0.01 ***p<0.001N B only significant results showed

Informal CG=partner or child 1.360**

N.B. only significant results showed


CONCLUSIONCONCLUSION

Large networks with high percentage of formal caregivers Large networks with high percentage of formal caregivers

Contact in few formal-informal relationships

Number of tasks matter The more tasks one caregiver

performs, the higher the chance (s)he will get in contact

ith th iwith other caregivers


DISCUSSIONDISCUSSION

Policy need for central informal and formal caregiverPolicy need for central informal and formal caregiver

Policy: more tasks per formal caregiver (i.e. less task

differentiation) characteristics of care/voluntary

organization matter as well (see presentation of Marieke van

Wieringen)Wieringen)


THANK YOU FOR YOUR ATTENTIONTHANK YOU FOR YOUR ATTENTION

More information:[email protected]

Faculty of Social Sciences

j @www.fsw.vu.nl/zorgnetwerk


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